Lia Fischi
Individual provider Active NPI Registered Nurse · Manlius, NY
NPI 1124200472 · NPPES record last updated Nov 28, 2007
Key facts
- NPI
- 1124200472
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 509970 (NY)
- Practice address
- 4520 Waltham Dr
Manlius, NY 13104-9591 - Phone
- (315) 682-5707
- NPI assigned
- Nov 28, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 509970 | NY | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 509970 | NY | Yes |
Addresses
Primary practice location
4520 Waltham Dr
Manlius, NY 13104-9591
Mailing address
4520 Waltham Dr
Manlius, NY 13104-9591
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02852624 | Medicaid | NY |
Other providers in Manlius, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.